(804) Advantages of face-to-face contact versus video conferencing in the delivery of a self-management program for people with epilepsy

Rationale: HOBSCOTCH (HOme-Based Self-management and COgnitive Training CHanges lives) is an evidence-based intervention that improves quality of life (QOL) in adults with epilepsy. The original eight-session program included six telephone sessions bookended by in-person sessions. To forgo transportation barriers, a virtual version was developed that replaced the two in-person sessions with video-conferencing. The current, multi-site replication study compared the two delivery methods head-to-head.

Methods: This trial enrolled 108 adults with epilepsy from four clinical sites across northern New England. Participants were randomized to receive either the HOBSCOTCH in-person intervention (n=20), the virtual intervention (n=17), or a six month waitlist-control period (n=48). This analysis compares the primary outcome of QOL (QOLIE-31) and the secondary outcome of subjective cognition (NeuroQOL-Cognitive Function), pre-and-post HOBSCOTCH.

Results: Compared to the control group, the in-person intervention group significantly improved in overall QOL score (p< 0.001) with a treatment effect of 12.4 points, and in subjective cognition total score (p < 0.001) with a treatment effect of 6.2 points. The virtual group had no statistically significant improvements versus control. In a pairwise comparison of the two versions of the program, the in-person group showed improvements in self-reported cognition (p=.01). While the treatment effect on overall QOL was 6.7 points higher for the in-person group versus the virtual group, the difference did not reach statistical significance.

A within-group analysis found overall QOL improvements from baseline for both in-person (p=0.002) and virtual (p=0.023). In-person HOBSCOTCH improved in subjective cognition (p=0.0001) while the virtual group did not. The control group had no change during this period. 

Conclusions: There appear to be critical advantages of face-to-face contact between participants and HOBSCOTCH Coaches. While 75% of the program was delivered identically, the two in-person sessions were not adequately replaced by video-conferencing sessions.

Funding: Please list any funding that was received in support of this abstract.: Centers for Disease Control and Prevention